Mixed infection with COVID-19 and tropical malaria (case report)

This article describes a clinical case of mixed infection with COVID-19 and tropical malaria. Patient Z., 37 years old, arrived from the Central African Republic with a diagnosis of “New coronavirus infection COVID-19, confirmed (PCR RNA SARS-CoV-2‘+’ from January 27, 2022) mild form.” During an objective examination, the subictericity of the sclera and skin integument attracted attention. During thermometry, an increase in body temperature to 39.0°C was found. Consciousness at the level of somnolence was observed. Hemodynamics was unstable, with episodes of arterial hypotension; heart rate was 96 beats per minute. Respiratory rate was 24 breaths in 1 minute, SpO₂ 95%, and with inspiratory dyspnea. According to the patient’s laboratory study results, severe thrombocytopenia, apparent signs of hepatic and renal insufficiency, hyperbilirubinemia, increased concentrations of C-reactive protein, and procalcitonin were revealed. A differential diagnostic search was performed between acute viral hepatitis and malaria. Blood microscopy revealed young trophozoites of Plasmodium falciparum (++++) using the thick drop method. Antimalarial therapy with Malacur was prescribed, which was then replaced with parenteral Quinine followed by mefloquine. In parallel, extracorporeal detoxification operations were performed. The patient’s condition was stabilized against adequate etiotropic therapy and complex intensive care measures. On the 40th day, the patient was discharged restored health.

The purpose of demonstrating a clinical case is to attract increased attention to the problem of imported cases of malaria, which, when combined with COVID-19 infection, may remain unrecognized for a long time, especially in cases where the diagnosis of COVID-19 receives rapid laboratory confirmation.

Adequate and timely antimalarial therapy, including a complex of intensive care measures supplemented with extracorporeal detoxification methods, is the basis for a successful outcome in patients with severe malaria with the development of severe complications.